Mental Health Referrals From Primary Care Doctors

More often than not, primary care physicians (PCPs) are the first professionals we see about any ailment or health issue, even if we have a specialist concern in mind. Although they’re usually not specifically trained to treat mental health, PCPs still often have a lot of “front-line” experience with it.^[1]

In fact, with one-fifth of primary care appointments addressing mental health difficulties, PCPs are not new to diagnosing, treating, and making referrals for mental health concerns.^[1]

Since many people prefer to remain with their primary care providers, it’s natural to wonder how they manage mental health concerns and the process of referring to other services. Yet mental health support that’s coordinated by primary care physicians can vary depending on local services and the professionals who work onsite.^[2]

If you’re curious about how mental health referrals from primary care doctors work, your physician or a mental health professional can talk you through the process. This article can also help explain mental health referrals from primary care doctors by discussing:

• What primary care doctors do at mental health appointments.
• Tips for navigating primary care with mental health issues.
• How primary care doctors refer people to mental health treatment.
• Mental health treatment options after a referral.
• Inpatient mental health care after a doctor’s referral.

What Do Primary Care Doctors Do at Mental Health Appointments?

With primary care services aiming to provide accessible healthcare for a wide range of needs, they welcome mental health appointments. These appointments are typically integrated across a handful of specialists, enabling many people to remain within the service.^[3]

At your appointment, primary care physicians will likely use screening questionnaires to gain an understanding of your condition, whether it’s depression, anxiety, or another concern. They may also use screening questionnaires again, at a later date, to monitor how you’re responding to treatment.^[4]

PCPs can address mental health concerns in several ways. For instance, they may give you a diagnosis, prescribe medication, or refer you to a counseling service.[[1 Some people will be able to receive therapy on site if the service has someone trained to deliver approaches like cognitive behavioral therapy (CBT).^[2]

Additionally, some services may have psychologists working on-site, which could allow you to get a quicker diagnosis and receive more in-depth therapeutic treatment. For example, such professionals might be able to address family needs and improve communication in individual, group, and family interventions.^[3]

Primary care providers could also have a social worker or behavioral health clinician on site. These professionals can discuss your symptoms and history, working with you to figure out the kind of care you need. They may also consult with a psychiatrist to develop a treatment plan.^[5]

In terms of prescriptions, PCPs tend to be more comfortable prescribing antidepressants, anti-anxiety medications, and mood stabilizers over antipsychotics. So, they may refer you to a specialist if you’re displaying psychotic symptoms.^[4]

Further, depending on your care provider’s specific setup, you may be able to receive a diagnosis and treatment within the same center. Otherwise, you may be referred to an external service.

How to Navigate Primary Care with Mental Health Issues

Even if there’s less stigma attached to seeing a primary care provider about your mental health than in the past, it’s still natural to feel nervous about your appointment. For instance, you may be aware of the limits these settings struggle with, such as brief appointment times, and worry you won’t be listened to.^[1]

The good thing about going to a primary care physician is that they can often treat multiple symptoms at once. Many physical health complaints can be explained by mental stress impacting your body, calling for a more holistic approach. In fact, those with mental health conditions are more likely to suffer from high blood pressure, asthma, and diabetes.^[2]

Primary doctors are well-placed to hear about your health as a whole, so don’t be afraid to bring all of your concerns to your appointment.^[2] Here are some helpful tips for navigating your appointment so that you express yourself clearly:^[6]

• Don’t wait for your doctor to ask about your mental health.
• Be honest about all your symptoms, including when they started and their severity.
• Prepare a list of your questions and concerns to bring to your appointment, and don’t be afraid to ask them.
• Bring a list of any medications or supplements you’re currently taking, and any in the past that you tried but didn’t help with your mental health.
• If there’s a history of mental illness in your family, mention this to your doctor. You may be more at risk for certain conditions.
• Consider bringing a friend or family member who can support you, take notes, or advocate on your behalf.

It can be tremendously nerve-wracking to speak to your doctor about your mental health. However, there will be a collaboration between primary care and mental health services, which we’ll explore next.

How Do Primary Care Doctors Make Referrals to Mental Health Treatment?

There isn’t a one-size-fits-all mental health referral process from clinical professionals like doctors. Your primary care provider may do things differently from another. However, if low mood is a concern, they’ll usually begin by asking how often, over the last fortnight, you have felt depressed and had little interest in pleasure in daily activities.^[5]

If you’re experiencing something other than depression, there’ll be a range of screening tools and questionnaires they may choose from, specializing in testing for anxiety, PTSD, and substance use issues. Positive results from screenings will likely lead PCPs to ask additional questions about your symptoms and begin a discussion about your treatment.^[4]

Many people only need a prescription and follow-up visits. However, if you require further specialist care, your PCP may recommend you meet with a psychotherapist. Typically, there won’t be a formal referral process for this, as people can find local therapists by checking approved providers from their insurance companies.^[5]

In the next section, we explore the different kinds of psychotherapy you may come across in your search.

Alternatively, you may be referred to a service that is co-located, which means it’s located in the same facility as your primary doctor.^[4] For instance, they may have a psychologist working on site, which will make it easy for you to be assessed, diagnosed, and treated with medication if necessary.^[3]

As we explore below, your PCP may refer you to more serious mental health care involving hospitalization. Preferably, this is done with your agreement. However, it may be an involuntary admission if you’re in crisis, suicidal, or a risk to yourself or others.

Mental Health Treatment Options After a Referral

When therapy is recommended by primary care providers, you usually have as much choice as your insurance provider allows. Your doctor may recommend a particular type of therapy or leave the choice up to you. The following are some of the most commonly recommended therapy approaches:

• Cognitive behavioral therapy (CBT): This involves exploring the automatic thoughts and behaviors that can worsen your condition. Therapists will challenge these patterns and help you develop new ways of thinking and behaving. It’s commonly used for those with anxiety, phobias, and obsessive-compulsive disorder (OCD).^[7]
• Psychodynamic therapy: Helping you explore your past and understand yourself more deeply. Therapists aim to connect past events, feelings, and relationships to current circumstances to identify any patterns that may be contributing to distress. This approach can help with a range of conditions, including depression and anxiety.^[7]
• Humanistic therapy: This approach believes all people are capable of becoming their true selves under the right conditions. So, therapists aim to create a non-judgmental, authentic, and empathic space in which you can explore your true feelings, thoughts, and wishes without external pressures. Humanistic therapy typically doesn’t involve diagnosing conditions, and it may not suit people who prefer a more directive form of therapy.

The most effective type of therapy will be the one in which you experience the best relationship with your therapist. When you’re treated with empathy, agree on the goals of therapy, and form a good rapport, the specific therapeutic approach sometimes doesn’t matter so much.^[7]

If your PCP determines your treatment requires medication (for instance, for psychosis or mood disorders), they may refer you to a psychiatrist who can provide both prescriptions and therapy.8 They might also refer you to services within your community if you need support with things like housing or employment.^[4]

Inpatient Mental Health Care

Your primary care physician may refer you to inpatient care if you’re experiencing severe symptoms of mental illness. This might be the case if you’re at risk of harming yourself or others, or simply unable to currently take care of your basic needs. In these residential settings, people are carefully monitored 24 hours a day, ensuring their physical safety and comprehensive mental health care.^[8]

Contrary to popular belief, inpatient care can be voluntary, with someone agreeing with their doctor that intensive care is the best course of action. These settings appear more residential than hospital rooms, with living spaces and common areas for eating and relaxing.^[8]

Inpatient programs for doctor-referred patients may admit you quickly if you’re in crisis. You’ll be evaluated on arrival and assigned a clinical caseworker. You may also be given blood and urine tests and asked about any medical conditions. If your admission is planned in advance, you’ll likely have time to pack some belongings to bring with you.^[8]

Residential programs for doctor referrals will give you access to a wide range of specialists. For instance, such settings will likely have social workers, psychiatrists, psychologists, nurses, music and art therapists, and nutritionists. These professionals all contribute to your care, creating an environment in which you’re treated physically, emotionally, and socially.^[8]

Further, inpatient centers tend to follow routines, with scheduled meals, classes, and therapy sessions every day. Usually, you’re able to see visitors, but with limits on how many attend in one go.^[8]

Though inpatient care can feel daunting, you may benefit from this kind of intensive treatment. Healthcare providers like Mission Connection can talk to you about whether such settings could help for your needs. Other options include outpatient programs that can range in intensity and provide support while also offering flexibility.

Get Mental Health Support at Mission Connection

Therapy options through primary care recommendations can vary, and it’s important you find one that suits you best. While many primary care doctors can signpost to valuable mental health services, sometimes contacting providers directly can better highlight the services available for your needs.

At Mission Connection, we’re committed to providing individualized care for every person we treat. Our team is trained in a variety of evidence-based treatment options, ensuring that care aligns with your unique goals.

We offer several options for effective outpatient treatment, including in-person programs at our locations, virtual telehealth, and a hybrid program that combines in-person and virtual care. Mission Connection is Joint Commission-accredited. We also accept most major insurance providers, so that recovery is not hindered due to financial issues.

Reach out to us online or call us at 866-833-1822 to find out how we can support your long-term recovery.